Application for a U.S. Passport

Forms and Documents

Document Name	Status
Form DS-11 Application for a U.S. Passport Form	Modified
Legal Authorities - DS-11 (10-2010).doc Supplementary Document	2010-10-19
DS-11 Supporting Statement (10-2010) V4.docx Supporting Statement A	2010-11-15
Air Change Justification.doc Justification for No Material/Nonsubstantive Change	2007-06-28
Legal Authorities--DS-11.doc Supplementary Document	2007-06-28

IC Document Collections

IC ID	Document Title	Status
14791	Application for a U.S. Passport Form	Modified

ICR Details

OMB Control No: 1405-0004	ICR Reference No: 201010-1405-003
Status: Historical Inactive	Previous ICR Reference No: 200710-1405-002
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Application for a U.S. Passport
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 12/09/2010
	Date Received in OIRA: 10/19/2010
Terms of Clearance: State has requested to withdraw this collection. Due to difficulties distributing the updated version proposed here, State will continue to use the previously approved version until it can be sure the new form is widely accessible.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2010	36 Months From Approved	02/28/2011
Responses	16,100,000	0	16,100,000
Time Burden (Hours)	22,808,333	0	22,808,333
Cost Burden (Dollars)	1,788,300,000	0	1,788,300,000

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Abstract: The information collected on the DS-11 is used to facilitate the issuance of passports to U.S. citizens and nationals. The primary purpose of soliciting the information is to establish citizenship, identity, and entitlement to the issuance of the U.S. passport or related service, and to properly administer and enforce the laws pertaining to the issuance thereof.

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Authorizing Statute(s): US Code: 22 USC 211a Name of Law: Authority to grant, issue, and verify passports
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1400-AC58	Final or interim final rulemaking	75 FR 123	06/28/2010

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 118	06/21/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 197	10/13/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Application for a U.S. Passport	DS-11, DS-11, DS-11, DS-11	Application for a US Passport ,   Aopplication for a U.S. PAssport ,   Application for a U.S. Passport ,   Application for a U.S. Passport

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Changes in hour burden are due to a decrease in estimated respondents and change in costs is due to an increase in passport fees.

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Annual Cost to Federal Government: $934,360

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/19/2010

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